慢性乙型肝炎非肝硬化和肝硬化肝癌患者的临床表现和结局

StephenW

Comparison of clinical manifestations and outcomes of noncirrhotic and cirrhotic hepatocellular carcinoma patients with chronic hepatitis B

Hwan, Yu Jung*,; Shin, Jongbeom*,; Jin, Young-Joo; Lee, Jin-Woo
European Journal of Gastroenterology & Hepatology: January 2020 - Volume 32 - Issue 1 - p 66–73
doi: 10.1097/MEG.0000000000001478
Original Articles: Hepatology
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Aim The differences of the clinical features and survival outcomes between cirrhotic and noncirrhotic hepatocellular carcinoma (HCC) patients with hepatitis B virus (HBV) infection remain to be determined. We evaluated clinical characteristics and survival outcomes of noncirrhotic HBV-associated HCC patients compared with cirrhotic patients.

Patients and methods Between January 2005 and December 2015, 1345 patients were diagnosed to have HCC at our hospital. Of these, 860 HBV-associated HCC patients with (cirrhotic group, n = 519, 60.3%) or without cirrhosis (noncirrhotic group, n = 341, 39.7%) were retrospectively analyzed. Propensity score matching (PSM) was used to adjust for differences between the two groups.

Results The noncirrhotic group had lower Child–Turcotte–Pugh (CTP) classes and greater tumor sizes and were less likely to have portal vein thrombosis than the cirrhotic group. Age and sex were not significantly different between the two groups. Cumulative overall survival (OS) rates at 2, 4, 6, and 8 years after treatment were significantly higher in the noncirrhotic group (67.2, 57.1, 43.2, and 38.3 vs. 58.3, 41.3, 33.2, and 27.8%, respectively, P < 0.001). However, no significant intergroup difference in OS rates was observed after PSM (P = 0.680). Significant predictive factors of OS were CTP class, tumor size, tumor number, and curative-intended treatment for the noncirrhotic group, and serum alanine aminotransferase, CTP class, tumor size, tumor number, and curative-intended treatment for the cirrhotic group.

Conclusion After PSM, cumulative OS rates were similar between HBV-related HCC patients with and without cirrhosis, and they were clearly dependent on CTP class, regardless of the presence of cirrhosis itself both in cirrhotic and noncirrhotic patients.

StephenW

慢性乙型肝炎非肝硬化和肝硬化肝癌患者的临床表现和结局比较

焕裕贞* ,;申钟be * ;;金英珠李镇宇
《欧洲胃肠病学和肝病学杂志》：2020年1月-第32卷-第1期-第66–73页
doi：10.1097 / MEG.0000000000001478
原始文章：肝病学
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目的乙型肝炎病毒（HBV）感染的肝硬化和非肝硬化肝细胞癌（HCC）患者的临床特征和生存结果的差异尚待确定。我们评估了与肝硬化患者相比，非肝硬化HBV相关HCC患者的临床特征和生存结果。

患者与方法2005年1月至2015年12月，我院共诊断出1345例HCC患者。在这些患者中，回顾性分析了860例HBV相关的HCC患者（肝硬化组，n = 519，60.3％）或无肝硬化（非肝硬化组，n = 341，39.7％）。倾向得分匹配（PSM）用于调整两组之间的差异。

结果非肝硬化组的Child-Turcotte-Pugh（CTP）等级较低，肿瘤大小较大，与肝硬化组相比，门静脉血栓形成的可能性较小。两组之间的年龄和性别无明显差异。非肝硬化组在治疗后2、4、6和8年的累积总生存（OS）率显着更高（分别为67.2、57.1、43.2和38.3，而58.3、41.3、33.2和27.8％，P <0.001）。然而，PSM后未观察到OS发生率的显着组间差异（P = 0.680）。 OS的重要预测因素是非肝硬化组的CTP类别，肿瘤大小，肿瘤数目和预期治疗；肝硬化组的血清丙氨酸氨基转移酶，CTP类别，肿瘤大小，肿瘤数目和预期治疗。

结论PSM后，无论是否患有肝硬化，无论是否存在肝硬化，HBV相关肝癌患者和没有肝硬化的HCC患者的累积OS率均相似，并且显然取决于CTP类型。